F-75 Therapeutic milk
Stabilisation phase in severe acute malnutrition
Recommendations for use
- Each 102.5g sachet should be reconstituted with 500 ml of drinking water in order to obtain about 600 ml of F-75 therapeutic milk. The dry extract and energy density of the final solution are 170 grams per liter and 75 kcal per 100 ml.
- Once reconstituted, F-75 therapeutic milk can be kept for 3 hours at room temperature, and up to 16 hours in a refrigerator. Beyond these limits, it becomes unfit for consumption and must be thrown away.
- In the stabilisation phase (phase 1), a child suffering from severe acute malnutrition should receive from 80 to 100 kcal / kg body weight / day (or 107 to 133 ml of F-75 / kg / day) for an average of 3 days. One carton contains sufficient product for the treatment (phase 1) of 35 children (weighing 5 kg) for a duration of 3 days.
Packaging and conservation
- Primary packaging: F-75 therapeutic milk is delivered in sachets containing 102.5 g of powder, packaged under protective atmosphere; the sachets are air and water tight, and protected from light. Sachets of F-75 can be used up to 24 months after the date of manufacture.
- Secondary packaging: cartons of 120 sachets (net weight : 12.3 kg ; gross weight : 13.76 kg).
- Palletisation by sea: Pallets with 40 cartons (net weight : 492 kg ; gross weight : 573.4 kg).
- Where possible, to be stored in a dry, cool area, at a temperature of less than 30°C.
F-75 therapeutic milk was specially developed for the stabilisation phase of people suffering from severe acute malnutrition, designated as phase 1 in the treatment protocol drawn up by the World Health Organisation (WHO This product must be used in therapeutic renutrition centres with medical supervision, and must not be distributed directly to families.
Main characteristics, target population and benefits obtained
F-75 is a therapeutic milk powder, to be reconstituted by diluting with drinking water. It was developed by Nutriset in compliance with specifications laid down by nutritionists. F-75 is designed for phase 1 of the treatment of severe acute malnutrition in a hospital situation. The stabilisation phase consists of ensuring children's rehydration and the treatment of any medical complications, while beginning renutrition.
When seriously malnourished children arrive at the hospital, they very often have infections, hepatic or intestinal deficiency, or electrolytic imbalances (excess or deficiency of elements such as sodium, potassium, calcium or magnesium). In this kind of condition, the organism is incapable of tolerating the usual quantities of proteins, fat or sodium. It is, therefore, essential to begin treatment by giving foods which are low in protein, fat and sodium and rich in carbohydrates. As well as skimmed milk powder, F-75 therapeutic milk contains vegetable fat, maltodextrin, sugar and a mineral and vitamin complex.
With its caloric density of 75 kcal per 100 ml of reconstituted milk, F-75 is not intended to make children put on weight, and its use should be limited to phase 1 (on average, 3 days). In phase 2, the nutritional recovery phase, F-100 therapeutic milk is used (or a ready-to-use nutritional equivalent such as Plumpy’nut®, depending on the child's state of health). F-75 milk can be given to children aged from 6 months up.
References
- La prise en charge de la malnutrition sévère : Manuel à l’usage des médecins et autres personnels de santé à des postes d’encadrement (Management of severe malnutrition: a manual for physicians and other senior health workers), OMS, 1999
http://www.who.int/nutrition/publications/severemalnutrition/9241545119/en/index.html - Golden MHN. Severe malnutrition. In: Weatherall DJ, Ledingham JGG, Warell DA, eds. The Oxford textbook of medicine. Oxford: Oxford University Press, 1995: 1278-96.
- Treatment of malnutrition in refugee camps, Conference by Mike Golden and André Briend; The Lancet, Volume 342, Issue 8867, 7 August 1993, Page 360
http://www.ncbi.nlm.nih.gov/pubmed/8101595
